Text-book of forensic medicine and toxicology

by R. J. M. Buchanan

Great care should be taken to follow carefully the marginal directions on the certificate form. The most trivial omission will invalidate the certificate. The omission of the name of the street and number of the house is sufficient to set it aside. A medical man should remember that, although his certificate may have passed the scrutiny of the Commissioners, it is liable to be made the subject of discussion in a Court of law, and in cross-examination he will have to support the statements therein made.

The following certificate properly filled up by Dr. Millar of Bethnal House Asylum, is given in his book on Hints on Insanity, and may be taken as an example of a correct certificate at that time, the present form being slightly different:—

MEDICAL CERTIFICATE
PROPERLY FILLED UP

1. Here set forth the	I, the undersigned,
qualification entitling the	John Millar, being a (¹)
person certifying to practise	Licentiate of the
as a physician, surgeon, or	Royal College of Physicians,
apothecary.	Edinburgh,
	and being in actual practice as
2. Physician, surgeon, or	a (²) Physician, hereby certify
apothecary, as the case	that I, on the third day of
may be.	November, One thousand eight
	hundred and eighty-eight_, a
3. Here insert the street and	(³) 600 - Cambridge Road,
number of the house (if	Bethnal Green, in the county of
any), or other like particular.	Middlesex, separately from any
	other medical practitioner,
	personally examined
	James Thompson, sen., of
4. Insert residence, and	(⁴) 600 Cambridge Road,
profession or occupation	Bethnal Green, gentleman,
(if any).	and that the said James Thompson,
	sen., is a person (⁵)
5. Lunatic, or an idiot,	of unsound mind, and a proper
or a person of unsound mind.	person to be taken charge of, and
	detained under care and treatment;
	and that I have formed this opinion
	upon the following grounds, viz.:—
6. Here state the facts.	1. Facts indicating insanity
	observed by myself (⁶)—
	He is incoherent in his
	conversation, violent in his
	conduct, and quite unable to
	take care of himself.
7. Here state the information,	2. Other facts (if any)
and from whom.	indicating insanity
	communicated to me by
	others (⁷)—
	His son, James Thompson, jun.,
	informs me that he has
	threatened to commit suicide,
	and has twice attempted it with
	a razor.
	(Signed) Name—JOHN MILLAR
Place of abode—Bethnal House, Bethnal Green.
Dated this third day of November,  One thousand eight hundred and eighty-eight.

Table relating to “Facts” of Insanity,

(compiled from Millar.)

Facts offering no Evidence of Insanity.

1. Refuses to take her medicine and resists

in every way; closes her teeth; threatens

to strike every one near her; obliged to

use the strait-waistcoat.

2. Violent in her temper, and very abusive.

3. Moody and irritable temperament, and of

weak memory in many particulars.

4. General restlessness of manner; considers

himself heavily involved in debt to many

thousand pounds; says he has been ruined

by the Government, and that he intends

prosecuting the Admiralty for £5000 damages.

Vague and Irrelevant Facts.

1. She is suspicious of her husband; says he

keeps bad company; she is most irritable and

jealous, and takes stimulating drinks to a

dangerous and exciting extent.

2. Obstinate; has the manner and appearance

of an insane person; complained of her head;

refused her food, and would not go

downstairs; melancholy.

3. He has imperfect sight; good hearing and

taste; he is unable to speak; his gait is

ape-like, and the skull-bones seem to have

fallen together from the want of cerebral

development. He will occasionally slap his

face and strike his hands; sometimes makes

a howling noise.

4. She is very good-tempered; but day and

night she talks almost incessantly;

occasionally sings. She says she comes from

Otaheite, and relates stories of thos

around her doing absurd things.

Good Facts.

1. She states that she is a lost person and

without hope of forgiveness; that she will

be taken to prison, and die a miserable

death; that the devil whispers in her ear

that she has committed the unpardonable sin.

2. Great taciturnity; complete seclusion

from society; aversion to cleanliness;

wandering about the streets at improper hours.

3. He states that he is a Prince of France;

that he possesses a palace, and has recently

had two fortunes left him (he cannot tell by

whom)—one of £400,000, the other of

£600,000; that he is going to Liverpool, a

distance of 150 miles, with a horse and

cart, which will take him four hours to go and

eight to return.

4. Inability to hold any rational

conversation; her manner and conduct are

totally at variance with her usual habits.

The following are examples of “Facts” sent back to be amended by the Commissioners—the emendations in italics:—

1. Incoherence, perversion of facts, delusion. Fancies that he possesses large amounts of money which people have secreted from him.